Minimally invasive enucleation of esophageal leiomyoma

Zaninotto, Giovanni; Portale, Giuseppe; Costantini, Mario; Rizzetto, Christian; Salvador, Renato; Rampado, Sabrina; Pennelli, Gianmaria; Ancona, Ermanno

doi:10.1007/s00464-005-0838-6

Cited by 50 publications

(33 citation statements)

References 7 publications

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“…Until recently, the ideal approach of MIE is not yet standardized. The optimal approach should be tailored for each patient according to the location and clinical stage of the tumor [20]. The purpose of this study was to evaluate the effects of MIE approach according to the location of the tumor and to compare differences in perioperative and long term clinical outcomes between patients with cancer arising in the upper third of the esophagus and those with tumors involving the middle and lower third of the esophagus.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive esophagectomy for esophageal cancer according to the location of the tumor: Experience of 251 patients

Chen

Liu

Wang

et al. 2017

Annals of Medicine &Amp; Surgery

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BackgroundMinimally invasive esophagectomy (MIE) is increasingly used for the treatment of esophageal cancer. However, the ideal approach of MIE is not yet standardized. We explore the ideal approach of MIE according to the location of the tumor and compare the clinical outcomes between patients with cancer arising in the upper third of the esophagus and those with tumors involving the middle and lower third of the esophagus.MethodsWe included patients with esophageal carcinoma and had clear indications for MIE. For cancer arising in the upper third of the esophagus, MIE McKeown approach was performed. For tumors involving the middle and lower third of the esophagus, MIE Ivor Lewis approach was adopted.ResultsOf the 251 patients included in this analysis, 200 patients underwent Ivor-Lewis MIE and 51 patients underwent McKeown MIE. The incidence of anastomotic leak, anastomotic stenosis and recurrent laryngeal nerve injury was significantly higher in the McKeown MIE group than that in the Ivor Lewis MIE group. The 30-day postoperative mortality rate was 1.2% (n = 1) in the McKeown MIE group. Lymph nodes harvested were significantly more in the MIE-McKeown group than in Ivor Lewis MIE group (P < 0.05). The median follow-up period was 15 months (1–25 months) and the overall survival rate at 1 year stratified by pathologic stage at esophagectomy was 95.9% (stage 1), 83.8% (stage II), 73.4% (stage III).ConclusionsMIE for esophageal cancer according to the location and clinical stage of the tumor will decrease all postoperative complications and may yield the greatest benefit from surgery.

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Section: Introductionmentioning

confidence: 99%

Minimally invasive esophagectomy for esophageal cancer according to the location of the tumor: Experience of 251 patients

Chen

Liu

Wang

et al. 2017

Annals of Medicine &Amp; Surgery

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“…The need to resect or not a leiomyoma is based on the symptoms it produces and on the differential diagnosis with Gastrointestinal Stromal Tumor (GIST) 9 . This report summarized the operative experience of distal esophageal leiomyoma performed resection in our department.…”

Section: Introductionmentioning

confidence: 99%

The results of surgical treatment of distal esophageal leiomyomatosis performed distal esophagectomy

et al. 2015

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SUMMARYObjective: Leiomyomas are the most common benign esophageal neoplasms. Surgical treatment is the therapy of choice for such tumors. In this study, we submitted results of 6 patients with distal esophageal leiomyomas who underwent surgical treatment during a 5-year period. The aim of the current study was to evaluate the long-term outcomes of patients with leiomyoma located at distal esophagus who had undergone distal esophagectomy and esophagogastrostomy. Method: Demographic features, clinical and laboratory findings including symptoms, diagnosis, histopathology, and results of surgical treatment were examined. Results: 6 patients (four women, two men; mean age 48.8y) were operated due to leiomyoma located at the lower esophagus. The most common symptoms were dysphagia and dyspepsia. Distal esophagectomy and esophagogastrostomy was performed to all patients with a median laparathomy and a right posterolateral thoracotomy. All patients were relieved from their symptoms without postoperative mortality, while pneumonia was occured in one patient which is treated medically. Conclusions: Esophageal leiomyoma is a benign tumor which becomes symptomatic in large seizes. Surgical resection is considered to be effective for distal esophageal leiomyomas, without complications. Keywords: Esophagus, leiomyoma, distal esophagectomy ÖZET Amaç: Leiomyomalar en sık görülen benign özofageal neoplazilerdir. Cerrahi tedavi bu tümör-lerde seçilen tedavi şeklidir. Bu çalışmada, 5 yıllık bir sürede distal özofageal leiomyoma nedeniyle cerrahi uygulanmış 6 hastanın tedavi sonuçlarını sunduk. Çalışmadaki amacımız distal özofa-gus yerleşimli leiomyoması olup distal özofajektomi ve özofagogastrostomi uygulanmış 6 hastanın uzun dönem sonuçlarını değerlendirmekti. Yöntem: Demografik özellikler, semptomlar, tanı, histopatolojiyi içerecek şekilde klinik ve laboratuar bulgular ve cerrahi tedavi sonuçları incelenmiştir. Bulgular: Distal özofagus yerleşimli leiomyoma nedeniyle 6 hasta ( 4 kadın, 2 erkek; ortalama yaş 48.8 yıl) opere edilmiştir. Disfaji ve dispepsi en sık görülen semptomlardı. Tüm hastalara median laparotomi ve sağ posterolateral torakotomi ile distal özofajektomi ve özofagogastrostomi uygulanmıştır. Hiçbir hastada mortalite gelişmemiş olup tüm hastaların semptomlarında iyileşme olmuştur; bir hastada pnömoni gelişmiş olup medikal olarak tedavi edilmiştir. Sonuç: Özofageal leiomyoma benign bir tümör olup büyük boyutlara ulaşınca semptomatik hale gelir. Distal özofageal leiomyomalarda cerrahi rezeksiyon etkili bir yöntemdir.

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“…10 Additionally, Dor fundoplication may be more amenable to a single-site surgical technique. 11 The risk for pseudodiverticulum of the esophagus after myotomy 12 is a concern raised primarily after the thoracoscopic approach; however, this phenomenon has been described in other laparoscopic and endoscopic procedures 13 and could be a risk in the Toupet procedure secondary to an uncovered myotomy.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Comparing Dor and Toupet After Heller Myotomy for Achalasia

Tomasko

Augustin

Tran

et al. 2014

JSLS

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Background:Laparoscopic Heller cardiomyotomy (LHC) is standard therapy for achalasia. Traditionally, an antireflux procedure has accompanied the myotomy. This study was undertaken to compare quality-of-life outcomes between patients undergoing myotomy with Toupet versus Dor fundoplication. In addition, we investigated overall patient satisfaction after LHC in the treatment of achalasia.Methods:One hundred thirty-five patients who underwent LHC over a 13-year period were identified for inclusion. Symptoms queried included dysphagia, heartburn, and bloating using the Gastroesophageal Reflux Disease–Health-Related Quality of Life Scale and a second published scale for the assessment of gastroesophageal reflux disease and dysphagia symptoms. The patients' overall satisfaction after surgery was also rated. Data were compared on the basis of type of fundoplication. Symptom scores were analyzed using chi-square tests and Fisher's exact tests.Results:Sixty-three patients completed the survey (47%). There were no perioperative deaths or reoperations. The mean length of stay was 2.8 days. The mean operative time for LHC with Toupet fundoplication was 137.3 ± 30.91 minutes and for LHC with Dor fundoplication was 111.5 ± 32.44 minutes (P = .006). There was no difference with respect to the incidence or severity of postoperative heartburn, dysphagia, or bloating. Overall satisfaction with Toupet fundoplication was 87.5% and with Dor fundoplication was 93.8% (P > .999).Conclusions:LHC with either Toupet or Dor fundoplication gave excellent patient satisfaction. Postoperative symptoms of heartburn and dysphagia were equivalent when comparing LHC with either antireflux procedure. Dor and Toupet fundoplication were found to have equivalent outcomes in the short term. We prefer Dor to Toupet fundoplication because of its decreased need for extensive dissection and better mucosal protection.

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Minimally invasive enucleation of esophageal leiomyoma

Cited by 50 publications

References 7 publications

Minimally invasive esophagectomy for esophageal cancer according to the location of the tumor: Experience of 251 patients

Minimally invasive esophagectomy for esophageal cancer according to the location of the tumor: Experience of 251 patients

The results of surgical treatment of distal esophageal leiomyomatosis performed distal esophagectomy

Quality of Life Comparing Dor and Toupet After Heller Myotomy for Achalasia

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